Shut down is all politics and not governance…

September 30, 2013

While what is going on in congress right now might be shameful, I’m thinking a lot about politics is shameful, so what else is new?

And make no mistake about it, the tussle over passing a continuing  resolution to fund the government in lieu of a budget is pure politics and has nothing whatsoever to do with the merits of Obamacare or the desires of the public in general.

I’m thinking right now, forget about it. Just let it happen and go from there.

I don’t think the same thing about the next fight which will be over whether to raise the debt ceiling. I mean if failing to raise the debt ceiling means that the full faith and credit of the United States of America for the first time in history means nothing, well that would seem disastrous and irresponsible. If that were to happen then I would think recall or voting them all out at the polls or whatever can be done would be in order.

Politics, although associated with, is not the same thing as governance, although you can’t have one without the other. Politics is a necessary evil. Right now we seem to have a congress that is incapable of governance. As for the executive, I’m not sure that is true. Certainly his refusal to submit to the demand of a minority — albeit a loud one (as Hillary said the other day) — that he drop his signature piece of legislation that is now law, the Affordable Health Care Act (aka Obamacare), is not a sign of his lack of governance.

And let’s don’t forget he has Iran talking diplomatically to us for the first time in 30-plus years (yes it’s just talk as of now).

Plus, the mere fact that he pushed through a form of universal health care, something that was first suggested by a Republican, Teddy Roosevelt, back the early part of last century, is certainly a sign of an ability at governance.

And of course the big irony that seems to always fall on deaf ears is that the president’s Republican opponent for his job last time around engineered the blue print for Obamacare in Massachusetts where he was governor (I’m talking good old I can’t believe I lost Mitt Romney).

Actually I was reminded this morning in a report on NPR that really only (well, should I say only?) 15 percent of the population lacks health care coverage.

But really the major problem is the ever-escalating cost. It is hoped that Obamacare can eventually bring down that cost by getting everyone into the insurance pool one way or the other. Basically or in general, the rule is that if you can afford to pay a share you will. Also the new law seems to be designed to introduce more competition into the health insurance market. As I have asked before — aren’t Republicans for competition in the free market?

I know that some are concerned that really Obamacare will turn into an eventual full government takeover in the health care business. I’m not sure that such is the case at all. I do know that many on the far left (and others too) would prefer a government takeover — that is a single-payer plan paid for by the government or read that taxpayers. But that is not what Obamacare is.

Whether all these new health care exchanges will work, I have not the foggiest notion. Maybe some think that they won’t and then the government will step in and take charge of it all. I don’t know what the thinking is.

But a big problem I understand is that young people, many of whom could afford or will be able to afford some kind of coverage, fail to purchase it, and might still under Obamacare. That means the pools are or will not be big enough and insurance costs go up because the smaller the pool the higher the risk for the insurance company.

But people who fail to protect themselves still demand care and our laws for the most part require it. We pay for them.

Now I do have issue with the claim when Obamacare was touted that if you have coverage you like you can keep it. That is true as long as it is still available. But with the new reality that Obamacare creates, there may be some question as to whether it will be. This remains to be seen.

Well I did not start out to talk about Obamacare specifically. I was just commenting on the politics of the threatened government shut down.

Obamacare is law. If there are problems with it then they can be worked out. The other side lost one and now it wants to have a second chance via its blackmail technique, that is to shut down the government and scare and make things inconvenient for the public and business and hope that the president who is of the opposing party and the legislators and others of the opposing party get blamed somehow.

If the shut down is short, probably few will notice. If it is prolonged, then as the pain is felt, there likely will be pressure from the constituents. It will be interesting to see how that plays out.

Politics is a game, albeit a deadly serious one at times.

P.s.

If this gambit works for the Republicans, will this be the new politics and will the Democrats pull the same stunt?

That would not be governance.


Maybe competition in the health care market via Obamacare will reduce costs…

September 21, 2013

Call it the law of unintended consequences or call it the Obamacare lie, but the claim that Obamacare will not mess with your current insurance plan is one of those.

But this could be good.

I just found out today that the company I work for may not provide health insurance next year due to the Affordable Health Care Act, aka Obamacare, becoming law — may not being key here. You see two things are happening:

On the one hand employers (with the exception of real small ones) are being required to offer health insurance or pay a penalty (and actually that goes for individuals too, that is everyone is required to have health insurance, or pay a penalty). But some companies are opting to or considering opting to paying the penalty. That is because it may be cheaper for them to pay the penalty than the contributions to a health care plan.

And secondly, consumers are being offered, or will be soon, health insurance plans through exchanges.

I am neither an Obamacare foe nor a supporter. I am neutral. I have read that once everything settles down (maybe over a few years) people will love it and take it for granted, much the same as Medicare or Social Security (oh, yeah, people rag on those too, but just try to mess them).

I am wondering why those in the GOP and those who claim to be free market supporters are opposing Obamacare if indeed it is offering competition in the market place. I think they are spreading the tale (which could have some truth to it) that Obamacare is introducing more government control. But health care has been getting more and more expensive and harder for people to afford and of course a lot of people have lost job-related health care because they have lost their jobs.

As part of the law, people without enough income will be offered a federal subsidy to purchase health care. The federal government through its existing programs has already been hit with ever-escalating debt due to its health care costs, and there has to be some order injected into the system.

The way it all works now is that those of us who pay out of our pockets for health care (even if we have insurance we pay the deductibles and copays and of course usually a premium) pay extra to cover the costs of those who pay nothing and who are are required by already-existing law to get at least some level of care. Poor people often just go to emergency rooms for everything from the common cold to broken bones to major diseases (I know about this because I have been in an emergency room more than once, bleeding profusely due to a cancerous condition I have, now in remission, and have had to wait for someone being treated for sniffles).

I have already written in previous blogs that I have not completely read up on Obamacare, but it looks like I may need to and so should everyone else now that it is the law.

While some in the Republican Party are vowing to dismantle or repeal the law, I doubt that will come to pass. And I honestly feel that their opposition is more for using Obamacare as a political football to advance other interests.

Again, I am neither a supporter or a foe of Obamacare. Right now I see the main effect of it as possibly offering some free market competition into the field of health insurance and an inducement for consumers to pay more attention to what they are paying for.

Correct me if I am wrong, but the trend has been to pay more and more for less coverage.

Oh, and I think what may happen is that a lot of people will opt for high deductibles so they are basically covering themselves for catastrophic occurrences rather than routine costs. That could be good or bad. The bottom line is that people will have to make more financial decisions. A more discriminating consumer could pull down some of those inflated health care costs.

We’ll see.

ADD 1:

I should have also noted above that some employers are now or are considering offering some type of health care stipend to employees to enable them to buy their own insurance plans as a benefit in lieu of the conventional one-plan fits all approach (gee sounds Republican to me).

And I also should have noted that  among the features of Obamacare are that insurance plans will not be allowed to exclude pre-existing conditions and parents will be able to keep their adult children on plans (that offer child coverage) to age 26.


No one seems to be adressing the cost issue of medical care…

September 19, 2013

With Republicans threatening to hold funding for Obamacare hostage in the upcoming federal debt ceiling debate with a threat to shut down the government, I got to feeling guilty that I wrote a long time ago that I would be studying Obamacare to see what it really offers. I began to do it but then it seemed what I would read would either be too complex or even too general and vague. That’s my excuse.

But meanwhile, my sister gave me a copy of a special edition of Time Magazine with the theme or story of “Why Medical Bills Are Killing Us”, by Steven Brill (March 4, 2013 issue). Everyone should read this (I give you a link at the end of this post). A lot of it you kind of already knew to some extent. Some of it is so outrageous and absurd that you just feel like throwing up your hands and giving up. I have not read all of it yet.

But really it reinforces the notion that our main problem in health care is it costs too much. We are being ripped off. You can read the article for specifics on costs, but there are things like marking things up 400 percent and more even when the health care providers get a price break by buying in volume. And it seems that although they more than get their money back on expensive equipment, you the patient end up paying for the equipment as if they had to buy it each time they used it. Sometimes the excuse is that they have to charge a lot in order to pay for all the charity cases they (hospitals) do. So that’s an excuse to misrepresent things? And how is it charity on the provider’s part if patients are actually paying for it all?

I think heretofore people have not worried so much, unless they were specific victims of the system, because, well, the insurance paid for it. If you were lucky enough to work at a place that provided you good insurance, generally speaking, no problem. And for those who are professional non-workers, well the government picks up the tab. It’s those good people caught in between who may have had the most problems.

And as I have always added, and will again, when I write on this subject, I thought that Medicare should have been expanded, extending coverage to those who have not qualified for it but whose economic position puts them in need of it, realizing that it is hard to make rules to fit that because everyone has his or her own story, and some people might just maneuver themselves into it to get free or cheaper coverage. Now I have really thought that a better system would be single-payer for all, the bill being paid collectively by us all as taxpayers. But the latter does not seem politically feasible in the United States, so never mind. Actually, if nothing works out, the time may come to pass when single-payer might seem more appealing to more people.

I’m not sure that Obamacare attacks the problem of cost. Maybe indirectly. But cost is the problem.

You see health care services are not set in a normal marketplace. Health care for the most part is a monopoly. It almost has to be. It is not practical to have competing services side by side. Oh, yes, cities sometimes have more than one hospital, but there is no real competition in price. And consumers, it is said, are not particularly “price sensitive” to costs. I mean in questions of life and death or at least health, people are not in a position or mood to haggle or bargain.  The Time article says you or your loved ones should be though. It can pay off.

The deal is that health care providers, especially hospitals, basically just make up the prices without any relationship to an actual market-driven price or true cost of delivering service (naturally with a reasonable return figured in). The sky is the limit. The article says they use something called the “chargemaster” as a beginning point and go down from there when forced to.

No one seems to know where this chargemaster came from or at least no one seems willing to admit it or explain it.

And I don’t think I will write much more about this now. I need to read more. However, I will note that the medical industry (and that is what it is, an industry) never seems to be held to account for its shenanigans.

That may because it has so much money and can pay for a lot of influence in government. I think I am correct in saying President Obama depended upon the medical establishment for getting his Obamacare through. To the extent the medical establishment helped him, they did so to head off single-payer, which Obama rejected.

And added to that — well who wants to insult doctors (and others in the field)? I mean I have a form of incurable cancer, although I am essentially in remission at this time. But I depended on and continue to depend upon the medical establishment. I try to tread lightly or at least not too heavily.

And I think medical professionals should be paid handsomely. And I think they could even in a system where there was some reality in the marketplace.

It is said that we in the United States pay more for our medical care than anywhere else in the world and get less for it.

I would like to see that money go for actual services, rather than bloated salaries for administrators and the private bureaucracy of insurance, and corporate profits (realizing that if care is to be served up through corporations, they do have to be profitable nonetheless).

That was also in the article, by the way, that is those bloated salaries of administrators, not to mention the kickbacks some doctors get for promoting some medicines and costly procedures.

And I want to note that the thoughts expressed here were not totally in or from the aforementioned article. Just my thinking on the subject. I need to read more and write more on this.

There are interests of the status quo who would like to do away with Obamacare. They attack it as a government takeover of health care and say people will be forced into essentially a stifling government system, with personal decisions taken out of the hands of patients and their health care professionals. To some extent that already exists, what with health care professionals having to adhere to requirements from insurers and the government.

Also, I think we all know, at least all thinking people know, that the attack on Obamacare is basically a straw man routine of sorts. It is a rallying cry to appeal to the masses in order to promote a wide range of special interest so-called conservative causes. Obamacare is always represented by the far right as socialism and a power grab by the all powerful state (as in the old communist nations).

(Now this may not fit in here, but this is, after all, a blog. But I do think to some extent Obamacare was misrepresented slightly when it was sold. Obama said time after time that it would not change coverage for those who already are covered and like their own insurance. But he failed to note that changing the law and dynamics of the system tends to make private providers want or have to change their offerings or their rate schedules. In other words, your old plan may no longer be available).

What Obamacare foes don’t say is how they could actually make sure everyone has health care (and indeed they may not think everyone should) and how they would get a handle on prices. Oh, I know. The market takes care of everything. Well I already addressed the fact that health care is not in a true marketplace (and maybe can’t be).

Finally, I think a lot of people just figure they will either have insurance through their job or if nothing else if they get sick or hurt they’ll get free care because the law already says you can’t be just left to die — well actually I think you can after fashion — but health care providers, particularly hospitals, are forced to provide emergency care to everyone, and then they pass the costs on to everyone.

But don’t feel too sorry for the hospitals. Even the non-profits are making huge profits (read the article).

The Time article I am reading is in a hard copy of the magazine. I first tried to find it on the computer but only got a teaser, but then I got the one I give you here. It at first glance seems like it might be a longer version of the one I am reading (not sure). But, whatever, you ought to read it. Information is power.

http://readersupportednews.org/opinion2/272-39/16241-time-why-medical-bills-are-killing-us


Threat of force seems to have had positive results, but Obama has to be ready if his bluff is called

September 19, 2013

I believe two things very strongly concerning the Syrian crisis:

A. President Obama’s threat to use military force has led to the Syrian government admitting it has chemical weapons and to agree (or at least state its agreement) to get rid of them.

B. That the plan to eliminate the weapons proposed by the Russians, whose client state is Syria, and the Syrian regime’s acquiescence may be somewhat of a stalling tactic.

But if the U.S. keeps the threat of military force alive and holds the parties to the agreement, then that has to be some form of success for Obama.

And the threat of force along with an election in Iran may have also had a positive outcome. The new president of Iran is on a public relations blitz, vowing to play nicey nice and has good words for Obama (and the far-right conspiracy fans are no doubt saying I told you Obama was a foreign agent), and I think I heard that he even wished the Israelis well. Seeing the American threat of force he may well feel that diplomacy is the better option for now.

The new Iranian president claims Iran has no intention, and never has, of producing nuclear weapons (a dubious claim). It just wants to have a right to develop nuclear power for peaceful purposes. Strange that an oil-rich nation has a need for nuclear.

My fear in this thing was that initially we seemed to be headed for one of those no-win military confrontations where we take half measures (as in “unbelievably small” as John Kerry put it) but spend a lot of money and get a lot of people killed and maimed for life, and accomplish nothing and even make things worse.

When you threaten force you do have to be willing to back up the threat if the other side calls your bluff, but then again, you don’t want to just strike to save face at the moment but have no plan or resolve to win.

Possibly the other side (and I mean the Russians, the Syrian regime, and Iran) is worried in this case, or it may be playing Obama. I don’t think that would be wise on the enemy’s part.


Politics of gun control gets in the way of common sense, budget cuts may affect security…

September 17, 2013

I have little time to post this, but I feel weird in that in a recent post, my second to last, I had just written something on gun control and about how gun control laws in and of themselves don’t control gun violence. And then another mass shooting. This time at the Navy Yard in Washington D.C. An apparently troubled individual shot 12 people dead and injured several others. The shooter was shot dead himself.

While I did not come down for or against gun control I have to note that here is still another case where someone with a history of violence and mental illness (well another, in some cases there had been no publicly known history, but in this one there was), and yet he had access to weapons (although some may have been grabbed at the shooting site) and even had a security clearance to get into the facility.

Does it seem like something is wrong here? Of course it does. We can’t protect ourselves from everything in a free society, but it seems we could do something. But we let the politics of gun control (for and against) rule us and throw common sense out the window. And budget cuts today are being blamed for less than stellar security.

I’ll write more later when I have the time and more information.

 

 

 


Allowing for partisanship, opinion piece may sum up Obama performance on Syria so far…

September 15, 2013

While I am relieved we are not so near now in making a strike on Syria that could and likely would lead to another war fiasco, what with the Russian idea (Kerry’s rhetorical suggestion? what Obama was working on all along? whatever) of having the Syrian regime hand over (or pretend to hand over, and otherwise stall) its chemical arsenal it claimed not to have, I have to wonder if we are letting Bashar al-Assad (the thug as the Obama administration calls him) off the hook and elevating his status in that we have to depend upon him to hand over the weapons and let UN inspectors in and so forth. Some of the rebels feel like they’ve been sold down the river (although who says they are or would be friendly to us?).

Who knows? Maybe the Obama administration has or is handling this whole thing correctly despite appearances of ineptitude.

I know the Washington Times has the mission of making Democrats look bad, but I thought this opinion piece was pretty good, allowing that the capital’s hard right wing daily is not about to give any credit whatsoever to Obama or anyone who is not on the right of the political spectrum. But anyway, if you have not read it, try it (it is at least good political satire): http://www.washingtontimes.com/news/2013/sep/15/curl-pwned-putin-obama-learns-about-cold-war/

And by the by, I also have to wonder what the Republicans would have done. Oh, yeah, George W. and mission accomplished and then a decade of war…

And it gets better, unless you are a Republican. The GOP is split, with the Tea Party becoming 60s anti-war hippies. Okay, to be fair it may be a little more complicated than all that, but in my adulthood the GOP has been the party of war hawks. And to be fair, the Democrats started the Vietnam War but had a hard time finishing it. Oooooo, we don’t want to escalate, we just want our boys killed by the hundreds each week, adding up to thousands. Well then the Republicans (and Democrats) in Iraq and Afghanistan have done much the same thing, meanwhile the general public remained ambivalent or disconnected, except maybe now the public has finally seen the futility of it all. Will our political establishment catch up?

I maintain war is something to be avoided. But when we are actually threatened (and the threat has to be clear) then we of course defend ourselves and give it what is needed, maybe all we’ve got. Nothing less than total domination/defeat or elimination of the enemy (of course we have to know who the enemy is — we can’t or should not just declare conventional war on evil as Bush did).


Social fabric more necessary than gun control…

September 15, 2013

If you make guns illegal then only criminals will have guns. That is the mantra of the pro-gun segment in society, and I think that  is a true statement.

I write this is reference to an article I just scanned (I’m being painfully honest here; I just scanned it) in the Huffington Post. In it you can read that in some places where guns are illegal the highest incidents of gun violence takes place.

Certainly, for example, we all have heard about the rampant gun violence in Mexico in the ongoing drug war there (which pits the government against drug lords and drug lords against each other, and puts citizens in the crossfire). If you’ve ever been near the border between the U.S. and Mexico then you have probably seen the warning signs: “Firearms are illegal in Mexico”. So much for gun control.

Now personally, I am neither and advocate of all-out gun freedom nor gun control per se. I do support the Second Amendment, even though I see it as at least somewhat ambiguous in its wording. I do, however, generally recognize that it has been seen as guaranteeing U.S. citizens the right to have firearms (with some limitations over the years imposed by law and the courts interpreting the law).

But laws by themselves don’t make us safe, social behavior does (or does not).

We do have to have law and respect for law.

And now I may be trailing off on some tangent, but part of the problem in Mexico is widespread corruption and a distrust in public institutions. This creates a culture of lawlessness. So even making guns illegal does not work there.

In the United States we have too large of a segment of society that is disconnected from the everyday workaday crowd. The breakdown of the family unit and widespread unemployment contribute to this, along with the breakdown of societal norms as the result of the sexual and social revolution of the 1960s (and too,  a shift in population from the farm to the city way before that, not to mention ongoing racial strife). Maybe I’m just making this up as  I go along. I’m just reaching back into my lifetime memory and observations at 64 plus years old.

We’re not going to go back in time, but we should recognize that we all have to get along lest we wind up like the Middle East where religious sect fights religious sect or tribes vie for power, and where a rich elite takes from the populace at large and snuffs out those who oppose them.

And I began all of this by noting an article mentioning gun violence and the connection or disconnection with gun control. Here is the article, for what it is worth: http://www.huffingtonpost.com/2013/04/10/most-violent-cities-in-the-world-mexico-honduras-brazil-colombia-venezuela_n_3053727.html?utm_hp_ref=latin-america